medicaid Archives - Page 16 of 16 - Syrtis Solutions Test

29 Jul GAO Finds Medicaid Needs to Boost Third Party Liability Initiatives

Posted at 21:44h in Third Party Liability

Why GAO Did This Study During fiscal year 2013, Medicaid - collectively funded by states and the federal government - delivered health care insurance coverage to over 70 million people at an overall cost of about $460 billion. Our lawmakers generally established Medicaid as the health...

29 Jun State Medicaid Third Party Liability Cost Avoidance Q & A

Posted at 21:43h in Third Party Liability

Recently, I got into a discussion with a state Medicaid TPL director about RFPs for third party liability cost avoidance work. I feel that our cost avoidance solution would greatly benefit state-run plans, but RFPs are nearly always written for a single vendor to handle an assortment of...

11 Jun Medicaid Cost Avoidance Through E-Prescribing

Posted at 20:46h in Payers of Last Resort

E-Perscribing: What it is, how it works, and how it can help Medicaid save millions of dollars Payer of last resort providers face the difficult task of recovering payments when the recipient does not present primary coverage information at the time services are rendered. For a...

29 Sep Bipartisan Leaders Seek Best Practices for Medicaid Managed Care Plans

Posted at 20:26h in Medicaid

Members of the House Energy and Commerce Committee and Senate Finance Committee sent out a letter to associations serving Medicaid health plans in pursuit of suggestions on best practices connected to cost controls, the use of data and quality of care. The leaders want to gain a...

05 Aug Insights on How the Medicaid Management Information System Makes Use of TPL Data

Posted at 12:59h in Third Party Liability

Third parties are organizations or people who are legally liable for paying the healthcare claims of Medicaid beneficiaries. Federal legislation and policies mandate states to guarantee that Medicaid is to be the payer of last resort. Medicaid beneficiaries are consequently obligated to utilize all other...

19 May Critical Steps to Curtail Medicaid Fraud

Posted at 20:53h in Medicaid

The watchdog for the U.S. Congress, the Government Accountability Office (GAO), designates Medicare and Medicaid as a high-risk plans, because it’s a complicated program, which is in danger from fraudulent activity. Fraud, in this case, involves deception resulting in a profitable gain at the expense...

29 Apr Legislation Could Lower Medicaid Abuse, Waste and Fraud

Posted at 18:38h in Medicaid

The Government Accountability Office (GAO), the watchdog for the U.S. Congress, determined that Medicaid and Medicare as programs with potential for a high risk of abuse, waste and fraud. In the case of Medicaid, the GAO says inadequate fiscal oversight might result in improper expenditures....

28 Oct 80% Medicaid Payments Lost Due to Poor Recovery Methods

Posted at 18:14h in Medicaid

A September 2001 report entitled “Medicaid Recovery of Pharmacy Payments by Liable Third Parties” by the U.S. Department of Health and Human Services’ (HHS) Office of Inspector General (OIG), who is charged with protecting healthcare cost containment and the integrity of HHS programs, found that...

13 Sep Effective TPL Plan Components That Ensures Cost Avoidance

Posted at 19:13h in Coordination of Benefits, Deficit Reduction Act, Medicaid, Payers of Last Resort, Third Party Liability

In the previous postings, we discussed the three main "practices" states should adopt in order to cost avoid and save taxpayer money. For states to have a truly effective TPL plan, timely discovery of any additional coverage is needed at the time of Medicaid enrollment....

medicaid Tag